{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:22:58Z","timestamp":1777634578254,"version":"3.51.4"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,12,9]],"date-time":"2014-12-09T00:00:00Z","timestamp":1418083200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Myeloid neoplasms are classified into five major categories. These patients may develop splenomegaly and require splenectomy to alleviate mechanical symptoms, to ameliorate transfusion\u2010dependent cytopenias, or to enhance stem cell transplantation. The objective of this study was to determine which clinical variables significantly impacted morbidity, mortality, and survival in patients with myeloid neoplasms undergoing splenectomy, and to determine if operative outcomes have improved over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The records of all patients with myeloid neoplasms undergoing splenectomy from 1993 to 2010 were retrospectively reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010nine patients (n\u2009=\u200989) underwent splenectomy for myeloid neoplasms. Over half of patients who had symptoms preoperatively had resolution of their symptoms post\u2010splenectomy. The morbidity rate was 38%, with the most common complications being bleeding (14%) or infection (20%). Thirty\u2010day mortality rate was 18% and median survival after splenectomy was 278 days. Decreased survival was associated with a diagnosis of myelodysplastic syndrome\/myeloproliferative neoplasm, anemia, abnormal white blood cell count, and hypoalbuminemia. Patients who underwent stem cell transplantation did not show an increased risk for morbidity or mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with myeloid neoplasms have a poor prognosis after splenectomy and the decision to operate is a difficult one, associated with high morbidity and mortality. <jats:italic>J. Surg. Oncol. 2015 111:389\u2013395<\/jats:italic>. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.23846","type":"journal-article","created":{"date-parts":[[2014,12,9]],"date-time":"2014-12-09T16:10:13Z","timestamp":1418141413000},"page":"389-395","source":"Crossref","is-referenced-by-count":11,"title":["Outcomes following splenectomy in patients with myeloid neoplasms"],"prefix":"10.1002","volume":"111","author":[{"given":"Kristy L.","family":"Rialon","sequence":"first","affiliation":[{"name":"Department of Surgery Duke University Medical Center Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul J.","family":"Speicher","sequence":"additional","affiliation":[{"name":"Department of Surgery Duke University Medical Center Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugene P.","family":"Ceppa","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine Indianapolis Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria R.","family":"Rendell","sequence":"additional","affiliation":[{"name":"Department of Surgery Duke University Medical Center Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven N.","family":"Vaslef","sequence":"additional","affiliation":[{"name":"Department of Surgery Duke University Medical Center Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Beaven","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Medical Oncology Duke University Medical Center Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas S.","family":"Tyler","sequence":"additional","affiliation":[{"name":"Department of Surgery Duke University Medical Center Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"III","given":"Dan G.","family":"Blazer","sequence":"additional","affiliation":[{"name":"Department of Surgery Duke University Medical Center Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,12,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.20009"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-04-083501"},{"key":"e_1_2_7_4_1","first-page":"253","article-title":"Splenectomy in myeloid metaplasia","volume":"30","author":"Hickling RA","year":"1937","journal-title":"Q J Med"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22021"},{"key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1001\/jama.1974.03230170040012","article-title":"Sex, splenectomy, and myeloid metaplasia","volume":"227","author":"Silverstein MN","year":"1974","journal-title":"JAMA"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V95.7.2226"},{"key":"e_1_2_7_8_1","first-page":"2831","article-title":"Allogeneic stem cell transplantation for agnogenic myeloid metaplasia: a European Group for Blood and Marrow Transplantation, Societe Francaise de Greffe de Moelle, Gruppo Italiano per il Trapianto del Midollo Osseo, and Fred Hutchinson Cancer Research Center Collaborative Study","volume":"93","author":"Guardiola P","year":"1999","journal-title":"Blood"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-06-1856"},{"key":"e_1_2_7_10_1","first-page":"359","article-title":"Risks and benefits of splenectomy in myelofibrosis: An analysis of 39 cases","volume":"36","author":"Lafaye F","year":"1994","journal-title":"Nouv Rev Fr Hematol"},{"key":"e_1_2_7_11_1","first-page":"200","article-title":"Splenectomy for patients with myelofibrosis with myeloid metaplasia: Pretreatment variables and outcome prediction","volume":"7","author":"Barosi G","year":"1993","journal-title":"Leukemia"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e318278d1bf"},{"key":"e_1_2_7_13_1","doi-asserted-by":"crossref","first-page":"2501","DOI":"10.1001\/archinte.1988.00380110129028","article-title":"Splenectomy in agnogenic myeloid metaplasia and postpolycythemic myeloid metaplasia. 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